Plasmodium falciparum and intestinal parasitic co-infections in HIV-infected patients in Benin City, Edo State, Nigeria

Abstract

Introduction: Human co-infection with Plasmodium falciparum and helminthes is ubiquitous throughout Africa. This study aimed to determine the co-infections of Plasmodium falciparum infection in HIV and intestinal parasitic infections, and their immunological distribution, in Benin City, Nigeria. Methodology: A total of 2,000 stool specimens from HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites using standard procedures. In addition, patients' blood samples were analyzed for CD4 counts by flow cytometry and examined for Plasmodium falciparum by microscopy. Results: The prevalence of single parasitic infection among HIV patients was 18.1% in males and 16.9% among females with no significant difference (p = 0.536) while gender was a risk factor in multiple parasitic infections (male versus female: 4.2% and 1.8% OR = 2.384; 95% CI = 1.371, 4.147) (p = 0.0025). Increasing age was not associated with increased risk of both single and multiple parasitic infections (p = 0.083; p = 0.248). CD4 + T cell count less than 200 cells/µl was a risk factor for acquiring single and multiple parasitic infections among HIV patients (OR = 5.565; 95% CI = 4.136, 7.486; p = 0.0001; OR = 4.283; 95% CI = 2.424, 7.566; p = 0.0001). The most common co-infection observed was between Plasmodium falciparum and Ascaris lumbricoides 43% (10) among HIV patients. Conclusion: This study provides evidence of co-infections between Plasmodium falciparum and intestinal parasites. Diagnosis of parasitic infections among HIV patients is advocated as this will enhance better management of HIV-infected patients.

Prevalence of Intestinal Parasites among Patients Accessing care in Secondary and Tertiary Healthcare Institutions in Edo State, Nigeria

“…Of the 8 parasites recovered, hookworm (75%) predominated, and this agrees with a previous report [10]. Previous reports from UBTH, ISTH and another tertiary hospital in a rural community of Edo State among HIV and non-HIV subjects indicated that Ascaris lumbricoides was the most prevalent intestinal parasites [12,[15][16][17][18][19]23]. Only one study among diabetic patients reported hookworm as the most prevalent intestinal parasites [9].…”

Co-Endemicity of Plasmodium falciparum and HIV-Infections in Treated Patients is Uncorrelated in Benin City, Nigeria

“…P. falciparum, helminthes, and the HIV virus are endemic in sub-Saharan Africa making co-infection a reality. Akinbo et al have previously reported co-infections of P. falciparum and Ascaris lumbricoides in HIV-infected patients in Benin City, Nigeria [22]. In this study involving 2,000 HIV-infected patients that were examined from August 2007 to August 2009, we found that 25.2% of the enrolled individuals were positive for P. falciparum [15].…”

“…The prevalence of anemia observed was 45.26% and is an important cause of anemia among HIV-infected patients on HAART [15]. Both HIV and Plasmodium infections can lead to anemia independently [21][22][23].…”

Haemoglobin recovery among HIV-1 infected patients on zidovudine-based antiretroviral therapy and other regimens in north-central Nigeria

“…[8][9][10] Nigeria is such a setting, with holoendemic malaria in much of the country, a significant burden of helminth infections, and nutritional deficiencies secondary to poverty. [11][12][13] Though ZDV is part of the recommended first-line regimen, Nigerian ART guidelines recommend avoiding the use of ZDV or switching to another drug in persons having baseline haemoglobin values of less than 8 g/dL. 14 We conducted a retrospective cohort study of HIV-infected patients in rural north-central Nigeria to track changes in haemoglobin levels during the first year of therapy in patients initiating ZDV-based regimens, stratified by baseline haemoglobin level.…”